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Ge J, Bo L, Zhang D, Wei X, Li J, Zhao J, Yue S, Xie Q, Shen P, Ma Z, Fang B, Yang C. Association between bilateral condylar resorption and reduced volumes of the craniofacial skeleton and masticatory muscles in adult patients: A retrospective study. Heliyon 2024; 10:e25037. [PMID: 38333825 PMCID: PMC10850897 DOI: 10.1016/j.heliyon.2024.e25037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 01/17/2024] [Accepted: 01/18/2024] [Indexed: 02/10/2024] Open
Abstract
Objectives This retrospective cohort study aimed to analyze volumes of craniomaxillofacial bone and masticatory muscles of young adults with bilateral idiopathic condylar resorption. Methods This was a retrospective cohort study of 84 adults with bilateral idiopathic condylar resorption (BCR) and 48 adults with normal temporal-mandibular joint (TMJ) matched for age and sex (mean age, 23.2 ± 3.6 years). The volumes of craniomaxillofacial bone and masticatory muscles, as well as intercondylar angle were measured. Unpaired t-tests and Pearson correlation tests were applied to analyze the data. Multivariable linear regression models were used to estimate the association between bilateral condylar volume and volumes of craniomaxillofacial bone and masticatory muscles adjusted for age, sex, and disc status. Results Compared to the control group, the BCR group displayed significant decreased volumes of craniomaxillofacial bone (p < 0.001), craniomaxillofacial bone without mandible (p < 0.001), mandible (p < 0.001), mandible without mandibular condylar process (p < 0.001), bilateral masseter muscle (p < 0.001) and bilateral temporalis muscle (p < 0.001), as well as the intercondylar angle (p < 0.001). These variables were significantly correlated to the volume of mandibular condylar process (0.5< r < 0.8; p < 0.001). By linear regression analyses, significant associations were found for the bilateral condylar volume with craniomaxillofacial bone volume and mandible bone volume. Conclusions Young adults with BCR displayed smaller volumes of craniomaxillofacial skeleton and masticatory muscles, and smaller intercondylar angle than the normal patients. The craniofacial musculoskeletal volume and intercondylar angle are associated with mandibular condylar process volume.
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Affiliation(s)
- Jing Ge
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Collage of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lingtong Bo
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Collage of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Dahe Zhang
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Collage of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiang Wei
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Collage of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiayi Li
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Collage of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jiong Zhao
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Collage of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shijing Yue
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Collage of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qianyang Xie
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Collage of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Pei Shen
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Collage of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhigui Ma
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Collage of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bing Fang
- Department of Orthodontics, Shanghai Ninth People's Hospital, Collage of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chi Yang
- Department of Oral Surgery, Shanghai Ninth People's Hospital, Collage of Stomatology, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Yang X, Li Q, Zhu S, Bi R. Comparison of Class II open bite correction by temporomandibular joint prostheses or bimaxillary orthognathic surgery. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101630. [PMID: 37689138 DOI: 10.1016/j.jormas.2023.101630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 08/30/2023] [Accepted: 09/06/2023] [Indexed: 09/11/2023]
Abstract
INTRODUCTION The aim of this study was to evaluate the outcome of skeletal Class II and anterior open bite patients who received simultaneous Le fort I osteotomies with temporomandibular joint (TMJ) prostheses or bimaxillary orthognathic surgery. MATERIALS AND METHODS Patients with condylar resorption (CR) were treated by TMJ prostheses and orthognathic surgery and divided into two groups. Cephalometric radiographs were obtained before and after operation to find out the surgical alteration by comparing measures at different time points. RESULTS 23 patients were included. Mean overbite of the patients was increased by 3.39 mm in TMJ prostheses group and 3.24 mm in orthognathic group. Occlusal plane angle was averagely rotated -6.06° and 1.31°; mandibular plane counterclockwise rotated 12.23° and 5.81°, respectively. The increase of ramus height in TMJ prostheses group were significantly greater than orthognathic surgery group (8.02 ± 1.96 mm vs. -0.09 ± 1.29 mm). The overall treatment effect was stable in both groups during the 1-year follow up. DISCUSSION Two surgical plans seem to be reliable treatments of anterior open bite and mandibular retrognathism caused by temporomandibular disease. TMJ prostheses with simultaneous Le fort I osteotomies close open bite by lengthening the height of ramus and rotating maxillo-mandibular complex counterclockwise, while bimaxillary orthognathic surgery by rotating maxilla clockwise and mandible counterclockwise without rebuilding ramus.
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Affiliation(s)
- Xianni Yang
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Qianli Li
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China
| | - Songsong Zhu
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China.
| | - Ruiye Bi
- State Key Laboratory of Oral Diseases & National Center for Stomatology & National Clinical Research Center for Oral Diseases & Department of Orthognathic and TMJ Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan 610041, China.
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Park C, Kim H, Ryu J, Jung S, Park HJ, Oh HK, Kook MS. Condylar volume and positional changes following a bilateral sagittal split ramus osteotomy in skeletal class II and III malocclusions. Maxillofac Plast Reconstr Surg 2023; 45:41. [PMID: 38008875 PMCID: PMC10678871 DOI: 10.1186/s40902-023-00408-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/18/2023] [Indexed: 11/28/2023] Open
Abstract
BACKGROUND Mandibular condyle remodeling and displacement are post-orthognathic surgery concerns that can potentially lead to occlusal issues after bilateral sagittal split ramus osteotomy. This retrospective study examined the relationship between condylar volume changes and position alterations after surgery in patients with skeletal class II and III malocclusions using cone-beam CT. METHODS The study included 16 patients (6 with Class II malocclusion, 10 with Class III malocclusion) who underwent bilateral sagittal split ramus osteotomy at Chonnam National University Hospital. Cone-beam CT data were collected at three specific time points: before surgery, immediately after surgery, and approximately 6 months post-surgery. Mandibular movement was measured using InVivoDental 5.4.6. ITK-SNAP 3.8.0 was used to assessed condylar volume changes post-surgery. Condyle positions were evaluated in four parts with RadiAnt DICOM Viewer 4.6.9. Statistical analyses were performed using the SPSS version 23. RESULTS Considering both Class II and III malocclusion, a 2.91% volume reduction was noted immediately and at 6 months after surgery. Both Class II and III cases demonstrated a decrease in superior joint space by -0.59 mm and medial joint space by -1.09 mm. No significant correlation was found between this process and condylar volume change. CONCLUSIONS The mandibular condyle volume decreased, and superior-medial movement of the condyle was detected in patients with Class II and III malocclusion immediately and at 6 months after surgery with no volume-position correlation.
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Affiliation(s)
- Chulyoung Park
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, 42, Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea
| | - Hyejin Kim
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, 42, Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea
| | - Jaeyoung Ryu
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, 42, Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea
| | - Seunggon Jung
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, 42, Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea
| | - Hong-Ju Park
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, 42, Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea
| | - Hee-Kyun Oh
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, 42, Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea
| | - Min-Suk Kook
- Department of Oral and Maxillofacial Surgery, School of Dentistry, Dental Science Research Institute, Chonnam National University, 42, Jebong-ro, Dong-gu, Gwangju, 61469, Republic of Korea.
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Phyo Thu A, Song S, Karmacharya N, Huang X, Zhou N. Three-dimensional analysis of the morphological changes of the craniofacial jaw and condyle in patients with idiopathic condylar resorption. Br J Oral Maxillofac Surg 2023; 61:598-604. [PMID: 37845098 DOI: 10.1016/j.bjoms.2023.08.206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 08/02/2023] [Accepted: 08/25/2023] [Indexed: 10/18/2023]
Abstract
In this study we aim to describe the three-dimensional analysis of condylar deformation of the temporomandibular joint (TMJ) and morphological changes of the craniofacial jaw in patients with idiopathic condylar resorption (ICR). We also compare those with a control group that is healthy and matched for age and gender. Cone-beam computed tomography (CBCT) and cephalometric radiograph (X-ray) were conducted and analysis of craniofacial measurement, condylar width, length, height, and condylar axial angle changes were done three-dimensionally using ProPlan CMF™ 3.0 software (Materialise). The craniofacial jaw measurements of the ICR patients were significantly different than the control group and the significant changes in the mandible can be seen in ICR patients according to the results of this study. The results of smaller condylar width and height in the ICR group reflect the smaller size of the condyle compared with an unaffected condyle. Also, both right and left sagittal condylar angles (p = 0.001 and p = 0.003), respectively, and axial condylar angles (p = 0.01 and p = 0.02), respectively, displayed significant differences between the two groups. In conclusion, the vertical development of the condyle decreased along with reduced measurements in the width and height of the condyle in ICR patients, and differences in the morphology of the craniofacial jaw and condylar angles were observed between study groups.
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Affiliation(s)
- Aung Phyo Thu
- Department of Orthodontics and Orthognathic Center, College and Hospital of Stomatology, Guangxi Medical University, Nanning, China.
| | - Shaohua Song
- Department of Orthodontics and Orthognathic Center, College and Hospital of Stomatology, Guangxi Medical University, Nanning, China; Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Guangxi Medical University, Nanning, China; Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction; Guangxi Clinical Research Center for Craniofacial Deformity, Nanning, China.
| | - Niluja Karmacharya
- Department of Orthodontics, College and Hospital of Stomatology, Guangxi Medical University, Nanning, China
| | - Xuanping Huang
- Department of Orthodontics and Orthognathic Center, College and Hospital of Stomatology, Guangxi Medical University, Nanning, China; Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Guangxi Medical University, Nanning, China; Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction; Guangxi Clinical Research Center for Craniofacial Deformity, Nanning, China
| | - Nuo Zhou
- Department of Orthodontics and Orthognathic Center, College and Hospital of Stomatology, Guangxi Medical University, Nanning, China; Department of Oral and Maxillofacial Surgery, College and Hospital of Stomatology, Guangxi Medical University, Nanning, China; Guangxi Key Laboratory of Oral and Maxillofacial Rehabilitation and Reconstruction; Guangxi Clinical Research Center for Craniofacial Deformity, Nanning, China
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The Retrospective Study of Magnetic Resonance Imaging Signal Intensity Ratio in the Quantitative Diagnosis of Temporomandibular Condylar Resorption in Young Female Patients. J Pers Med 2023; 13:jpm13030378. [PMID: 36983560 PMCID: PMC10057084 DOI: 10.3390/jpm13030378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 02/12/2023] [Accepted: 02/13/2023] [Indexed: 02/24/2023] Open
Abstract
According to the literature, there is no reliable and quantitative method available for the diagnosis and prognosis of early or potential temporomandibular joint (TMJ) condylar resorption (CR) thus far. The purpose of this study was to raise a new noninvasive method to quantitatively evaluate condylar quality using the signal intensity ratio (SIR) on magnetic resonance imaging (MRI) in order to assist in the diagnosis of TMJ CR. A retrospective exploratory study was performed to compare the condyle-to-cerebral cortex signal intensity ratios (SIR) on MRI among young female patients. We included 60 patients, and they were divided into three groups: the bilateral normal TMJ group (group 1), the bilateral TMJ anterior disc displacement (ADD) but without CR group (group 2), and the bilateral TMJ anterior disc displacement (ADD) with CR group (group 3). The SIR difference between the three groups was analyzed by the Kruskal–Wallis test (K-W test). The sensitivity, specificity, accuracy, and area under curve (AUC) were calculated by the receiver operating characteristic (ROC) curves. There was high consistency between the surgeon and the radiologist in the evaluation of the magnetic signal intensity with intraclass correlation coefficients of 0.939–0.999. The average SIR was 1.07 in the bilateral normal TMJ group (group 1), 1.03 in the ADD without CR group (group 2), and 0.78 in the ADD with CR group (group 3). It could be found by the K-W test that group 3 was significantly different from group 1 and group 2 (p < 0.05), while there was no significant difference between group 1 and group 2. The optimal critical SIR value was 0.96 for the diagnosis of CR according to the ROC curves and Youden index (p < 0.001, AUC = 0.9). The condyle-to-cerebral cortex SIR can be used as a noninvasive diagnostic tool for the quantitative evaluation of condylar quality and diagnosis and prognosis of CR. SIR ≥ 0.96 indicates a healthy condyle, while SIR < 0.96 is considered the optimal critical value for the diagnosis of CR. These findings are important for personalized and accurate treatment and prognosis prediction.
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Longitudinal effects of estrogen on mandibular growth and changes in cartilage during the growth period in rats. Dev Biol 2022; 492:126-132. [DOI: 10.1016/j.ydbio.2022.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 09/08/2022] [Accepted: 10/10/2022] [Indexed: 11/19/2022]
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Balaji SM, Balaji P, Joseph C, Nishanth S. Idiopathic bilateral mandibular condylar resorption causing anterior open bite - A case report. Indian J Dent Res 2022; 33:465-468. [PMID: 37006017 DOI: 10.4103/ijdr.ijdr_883_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2023] Open
Abstract
Introduction Mandibular condylar resorption (MCR) is a rare pathological entity, often affecting young females. Patient Concerns It is accompanied by pain, malocclusion and compromised quality of life including aesthetic perception. Due to this multiplicity of features, the diagnosis, treatment and management of MCR are always a challenge. Diagnosis This article reports a 25-year-old female suffering from progressive temporomandibular joint pain and compromised aesthetics. This article describes the clinical and radiological findings of this case. Treatment The possible aetiopathogenesis and treatment are described.
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Affiliation(s)
- S M Balaji
- Department of Oral and Maxillofacial Surgery, Balaji Dental and Craniofacial Hospital, Chennai, India
| | - Preetha Balaji
- Department of Oral and Maxillofacial Surgery, Balaji Dental and Craniofacial Hospital, Chennai, India
| | - Chris Joseph
- Department of Radiology, Tagore Medical College and Hospital, Rathinamangalam, Chennai, India
| | - Sachin Nishanth
- Department of Orthopaedics, Balaji Dental and Craniofacial Hospital and Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India
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Shen P, Zhang D, Luo Y, Abdelrehem A, Yang C. Characteristics of patients with temporomandibular joint idiopathic condylar resorption. Cranio 2022:1-7. [PMID: 35880737 DOI: 10.1080/08869634.2022.2100973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
OBJECTIVE To investigate characteristics of temporomandibular joint (TMJ) idiopathic condylar resorption (ICR) and analyze the related factors. METHODS A total of 755 consecutive patients (150 with ICR and 605 with anterior disc displacement [ADD]) from July 2015 to December 2018 were recruited. A comprehensive questionnaire characterizing the multidimensional impact of the TMJ was designed. Clinical examination and radiological evaluation were also performed. The odds ratio for each variable in the ICR group versus the ADD group was computed using logistic regression analysis. RESULTS Multivariate logistic regression analysis showed significant correlations between mouth opening restriction, disease course, mandibular retrusion, mandibular retrusion progression, skeletal Class II profile, and overjet in ICR patients. CONCLUSION These results suggest that a longer ADD disease course might have a strong relationship with ICR.
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Affiliation(s)
- Pei Shen
- Department of Oral Surgery, Shanghai Ninth People's Hospital; Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases, Shanghai, China
| | - Dahe Zhang
- Department of Oral Surgery, Shanghai Ninth People's Hospital; Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases, Shanghai, China
| | - Yi Luo
- Department of Oral Surgery, Shanghai Ninth People's Hospital; Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases, Shanghai, China
| | - Ahmed Abdelrehem
- Department of Craniomaxillofacial and Plastic Surgery, Faculty of Dentistry, Alexandria University, Egypt
| | - Chi Yang
- Department of Oral Surgery, Shanghai Ninth People's Hospital; Shanghai Key Laboratory of Stomatology, Shanghai Jiao Tong University School of Medicine; College of Stomatology, Shanghai Jiao Tong University; National Center for Stomatology; National Clinical Research Center for Oral Diseases, Shanghai, China
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Hua J, Lu C, Zhao J, Yang Z, He D. Disc repositioning by open suturing vs. mini-screw anchor: stability analysis when combined with orthognathic surgery for hypoplastic condyles. BMC Musculoskelet Disord 2022; 23:387. [PMID: 35473596 PMCID: PMC9039607 DOI: 10.1186/s12891-022-05337-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/19/2022] [Indexed: 11/25/2022] Open
Abstract
Background Disc repositioning by Mitek anchors for anterior disc displacement (ADD) combined with orthognathic surgery gained more stable results than when disc repositioning was not performed. But for hypoplastic condyles, the implantation of Mitek anchors may cause condylar resorption. A new disc repositioning technique that sutures the disc to the posterior articular capsule through open incision avoids the implantation of the metal equipment, but the stability when combined with orthognathic surgery is unknown. The purpose of this study was to evaluate the stability of temporomandibular joint (TMJ) disc repositioning by open suturing in patients with hypoplastic condyles when combined with orthographic surgery. Methods Patients with ADD and jaw deformity from 2017 to 2021 were included. Disc repositioning by either open suturing or mini-screw anchor were performed simultaneously with orthognathic surgery. MRI and CT images before and after operation and at least 6 months follow-ups were taken to evaluate and compare the TMJ disc and jaw stability. ProPlan CMF 1.4 software was used to measure the position of the jaw, condyle and its surface bone changes. Results Seventeen patients with 20 hypoplastic condyles were included in the study. Among them, 12 joints had disc repositioning by open suturing and 8 by mini-screw anchor. After an average follow-up of 18.1 months, both the TMJ disc and jaw position were stable in the 2 groups except 2 discs moved anteriorly in each group. The overall condylar bone resorption was 8.3% in the open suturing group and 12.5% in the mini-screw anchor group. Conclusions Disc repositioning by open suturing can achieve both TMJ and jaw stability for hypoplastic condyles when combined with orthognathic surgery.
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Affiliation(s)
- Jiangshan Hua
- Department of Oral SurgeryShanghai Key Laboratory of Stomatology &National Clinical Research Center of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Chuan Lu
- Department of Oral SurgeryShanghai Key Laboratory of Stomatology &National Clinical Research Center of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Research Institute of Stomatology, Shanghai, China
| | - Jieyun Zhao
- Department of Oral SurgeryShanghai Key Laboratory of Stomatology &National Clinical Research Center of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Research Institute of Stomatology, Shanghai, China.
| | - Zhi Yang
- Department of Oral and Cranio-Maxillofacial SurgeryShanghai Key Laboratory of Stomatology &National Clinical Research Center of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Research Institute of Stomatology, Shanghai, China.
| | - Dongmei He
- Department of Oral SurgeryShanghai Key Laboratory of Stomatology &National Clinical Research Center of Stomatology, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Research Institute of Stomatology, Shanghai, China.
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Gharavi SM, Qiao Y, Faghihimehr A, Vossen J. Imaging of the Temporomandibular Joint. Diagnostics (Basel) 2022; 12:diagnostics12041006. [PMID: 35454054 PMCID: PMC9031630 DOI: 10.3390/diagnostics12041006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 04/01/2022] [Accepted: 04/14/2022] [Indexed: 12/14/2022] Open
Abstract
Temporomandibular disorder (TMD) is a common musculoskeletal condition that causes pain and disability for patients and imposes a high financial burden on the healthcare system. The most common cause of TMD is internal derangement, mainly secondary to articular disc displacement. Multiple other pathologies such as inflammatory arthritis, infection, and neoplasm can mimic internal derangement. MRI is the modality of choice for evaluation of the TMJ. Radiologists need to be familiar with the normal anatomy and function of the TMJ and MR imaging of the internal derangement and other less common pathologies of the TMJ.
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Munakata K, Miyashita H, Nakahara T, Shiba H, Sugahara K, Katakura A, Nakagawa T. The use of SPECT/CT to assess resorptive activity in mandibular condyles. Int J Oral Maxillofac Surg 2021; 51:942-948. [PMID: 34937677 DOI: 10.1016/j.ijom.2021.11.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 08/30/2021] [Accepted: 11/26/2021] [Indexed: 12/20/2022]
Abstract
The aim of this study was to clarify the clinical significance of bone metabolism in the mandibular condyles in determining condylar resorptive changes. Twelve condyles of patients with idiopathic condylar resorption and degenerative joint disease were analysed using 99mTc HMDP SPECT/CT at baseline and subsequent computed tomography during the follow-up period. Twenty-two healthy condyles were enrolled as controls. After generating three-dimensional SPECT/CT images, two independent observers scored the degree of condylar uptake and measured the morphological changes in the condylar height and condylar volume. In the group with positive condylar uptake, the follow-up computed tomography showed significant decreases in condylar height (-1.69 ± 0.93 mm) and condylar volume (-12.51 ± 10.30%) when compared to healthy controls (condylar height, 0.09 ± 0.54 mm; condylar volume, -0.29 ± 4.22%) (P < 0.001). Moreover, the degree of uptake correlated with the changes in condylar height (observer 1, P = 0.012; observer 2, P = 0.039) and condylar volume (observer 1, P = 0.005; observer 2, P = 0.037). These results suggest that condylar bone metabolism is closely related to the resorptive activity. Thus, SPECT/CT would be useful in the prognostic evaluation or determination of treatment strategies for idiopathic condylar resorption and degenerative joint disease.
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Affiliation(s)
- K Munakata
- Department of Dentistry and Oral Surgery, Keio University School of Medicine, Tokyo, Japan
| | - H Miyashita
- Department of Dentistry and Oral Surgery, Keio University School of Medicine, Tokyo, Japan.
| | - T Nakahara
- Department of Radiology, Keio University School of Medicine, Tokyo, Japan
| | - H Shiba
- Department of Dentistry and Oral Surgery, Keio University School of Medicine, Tokyo, Japan
| | - K Sugahara
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, Japan
| | - A Katakura
- Department of Oral Pathobiological Science and Surgery, Tokyo Dental College, Tokyo, Japan
| | - T Nakagawa
- Department of Dentistry and Oral Surgery, Keio University School of Medicine, Tokyo, Japan
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Lee E, Crowder HR, Tummala N, Goodman JF, Abbott J, Zapanta PE. Temporomandibular disorder treatment algorithm for otolaryngologists. Am J Otolaryngol 2021; 42:103155. [PMID: 34214714 DOI: 10.1016/j.amjoto.2021.103155] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Revised: 06/20/2021] [Accepted: 06/21/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To review current literature describing the management of temporomandibular disorder (TMD) and to propose an evidence-based algorithm for otolaryngologists. DATA SOURCES A literature review using PubMed and Scopus was conducted to identify manuscripts that describe TMJ disorder etiology, diagnostic methods, and management across the fields of otolaryngology, general practice medicine, physical therapy, dentistry, and maxillofacial surgery. REVIEW METHODS Two reviewers subjectively evaluated the studies based on the inclusion criteria, incorporating them into a comprehensive algorithm. CONCLUSIONS TMD is one of the most common conditions presenting to otolaryngology outpatient clinics. Etiologies of TMD vary widely, including myofascial, intraarticular, neurologic, traumatic, or psychiatric in origin. When conservative measures fail to produce symptom relief, alternative treatments and referral to outside specialists including psychiatry, physical therapy, dentistry, and maxillofacial surgery may be indicated. Premature or inappropriate referrals may lead to patients suffering TMD for extended periods of time, with alternating referrals between various specialists. Thus, we present a TMD treatment algorithm for otolaryngologists to aid in the decision-making process in managing TMD. IMPLICATIONS FOR PRACTICE Patients frequently present to otolaryngology outpatient clinics for symptoms of TMD. Multidisciplinary practice may be necessary to effectively treat TMD of varying etiology and severity. Following conservative treatment, appropriate referrals and treatment plans will reduce ineffective use of resources, deferral of treatment, and patient suffering. For this reason, a comprehensive algorithm for otolaryngologists will improve resource utilization and efficiency of treatment to ultimately provide improved treatment outcomes for patients.
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13
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Noh HK, Park HS. Considerations for vertical control with microimplants in a idiopathic condylar resorption patient: A case report. J Orthod 2021; 48:172-182. [PMID: 33761768 DOI: 10.1177/14653125211002211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Idiopathic condylar resorption (ICR) is a rare, destructive temporomandibular joint disease characterised by progressive resorption of the condyles. This case report presents a record of an orthodontically treated patient with ICR with favourable posttreatment remodelling of the condyles. An 18-year-old woman sought treatment for ICR. A severe Class II high-angle facial pattern with resorption of bilateral condyles was evident. The treatment plan was determined after careful examination of condylar radiographs and comprised forward rotation of the mandible through full-arch intrusion with microimplants after extraction of the four premolars. The treatment was completed in 35 months, and the patient was noted to have a straight profile, good interdigitation and slightly increased condylar volume. Two years after retention, the condyles were stable, and the patient's profile and occlusion remained acceptable despite a mild relapse of the mandibular position. ICR was successfully corrected with orthodontic treatment. Counter-clockwise mechanics applied during the ICR remission period not only improved facial aesthetics but were also suitable for condylar unloading.
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Affiliation(s)
- Hyung-Kyu Noh
- School of Dentistry, Kyungpook National University, Jung-gu, Daegu, Republic of Korea
| | - Hyo-Sang Park
- School of Dentistry, Kyungpook National University, Jung-gu, Daegu, Republic of Korea
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14
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Zhou J, Fu Y, Yu L, Li Z, Chen S. A novel three-dimensional morphological analysis of idiopathic condylar resorption following stabilisation splint treatment. J Oral Rehabil 2021; 48:560-567. [PMID: 33539541 DOI: 10.1111/joor.13154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Revised: 01/18/2021] [Accepted: 01/27/2021] [Indexed: 12/30/2022]
Abstract
Bone modelling evaluation is important for monitoring idiopathic condylar resorption (ICR) progress. To compare condylar modelling in ICR patients treated with or without stabilisation splints (SSs). Eighty-four condyles from 84 ICR patients were studied: 42 received SS therapy (SS group); 42 received conventional therapy (control group). Cone-beam computed tomography images at diagnosis (T0) and after at least 6 months (T1) were used for three-dimensional reconstruction. Volume differences between T0 and T1 (δV) were used to evaluate the amount of modelling. Percentage of growth area (PCT) was used to assess the condylar surface growth tendency. No significant change in condylar volume was found in the SS group, whereas that in the control group was significantly decreased at T1 (P <.0001). The amount of modelling differed among condylar subregions within the SS group: among 6 subregions (P =.0137), between anterior and posterior regions (P =.0336) and between lateral, intermediate and medial regions (P =.0275). Control group condylar subregions showed no significant differences in the amount of modelling. The anabolic modelling tendency of the total condylar surface in the SS group was greater than that in the control group (P =.0251); however, there were no statistical differences in PCTs among condylar subregions in either group. SS therapy effectively reduced further bone destruction and promoted condylar modelling. Three-dimensional morphological analysis is a novel method that can accurately evaluate the amount of bone modelling and growth tendency in ICR patients.
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Affiliation(s)
- Jialiang Zhou
- State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Yujie Fu
- School and Hospital of Stomatology, Tongji University, Shanghai Engineering Research Centre of Tooth Restoration and Regeneration, Shanghai, China
| | - Lixia Yu
- State Key Laboratory of Oral Disease, Department of Temporomandibular Joint, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Ziyu Li
- State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Song Chen
- State Key Laboratory of Oral Disease, Department of Orthodontics, West China School of Stomatology, Sichuan University, Chengdu, Sichuan, China
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15
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Yuan M, Xie Q, Shen P, Yang C. Do sex hormone imbalances contribute to idiopathic condylar resorption? Int J Oral Maxillofac Surg 2021; 50:1244-1248. [PMID: 33632575 DOI: 10.1016/j.ijom.2021.01.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2020] [Revised: 10/22/2020] [Accepted: 01/21/2021] [Indexed: 11/18/2022]
Abstract
Idiopathic condylar resorption (ICR) is an aggressive form of temporomandibular joint disease that most frequently presents in adolescent girls during the pubertal growth spurt. Although numerous studies have indicated that the etiopathogenesis of ICR may be related to estrogen deficiency, the decisive role of estrogens remains controversial, and other sex hormone disturbances have not yet been investigated in this regard. Therefore, the aim of this study was to ascertain the role of serum estrogen levels and also the roles of other sex hormones in the pathogenesis of ICR. Ninety-four ICR patients and 324 disc displacement (DD) patients, of both sexes, were enrolled. Information on menstruation and serum levels of follicle-stimulating hormone, luteinizing hormone, prolactin, 17β-estradiol (E2), testosterone, and progesterone were recorded and analyzed. The results showed that female ICR patients had normal puberty onset, within the average age range. Use of oral contraceptives and other menstruation-regulating pharmaceuticals was similar in the two groups. Of note, neither serum E2 levels nor those of the other sex hormones differed significantly between female ICR and DD patients. However, male ICR patients had significantly increased serum testosterone levels (P=0.002) and relatively higher E2 levels (P=0.095) compared to DD patients. This study found that reduced serum E2 did not contribute to ICR; instead, systemic testosterone disturbances were found to be related to ICR.
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Affiliation(s)
- M Yuan
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China
| | - Q Xie
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China
| | - P Shen
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China.
| | - C Yang
- Department of Oral Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology and Shanghai Research Institute of Stomatology, National Clinical Research Center of Stomatology, Shanghai, China.
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16
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Zarour CC, Robinson C, Mian A, Al-Hameed M, Vempala M. Idiopathic Mandibular Condyle Resorption. Cureus 2020; 12:e11365. [PMID: 33304698 PMCID: PMC7721076 DOI: 10.7759/cureus.11365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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17
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Mao Y, Chen X, Yu S, Xu W, Qin H, Zhen J, Qiu Y, Zhang S, Yang C. Biomechanical analysis of costochondral graft fracture in temporomandibular joint replacement. Sci Rep 2020; 10:17754. [PMID: 33082437 PMCID: PMC7576606 DOI: 10.1038/s41598-020-74548-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 10/05/2020] [Indexed: 12/03/2022] Open
Abstract
This study is the first attempt to explore the reason of costochondral graft fracture after lengthy mandible advancement and bilateral coronoidectomy by combining finite element analysis and mechanical test. Eleven groups of models were established to simulate costochondral graft reconstruction in different degrees of mandible advancement, ranging from 0 to 20 mm, in 2 mm increment. Force and stress distribution in the rib-cartilage area were analyzed by finite element analysis. Mechanical test was used to evaluate the resistance of the rib-cartilage complex. Results showed a sharp increase in horizontal force between 8 and 10 mm mandible advancement, from 26.7 to 196.7 N in the left side, and continue increased after 10 mm, which was beyond bone-cartilage junction resistance according to mechanical test. Therefore, we concluded that bilateral reconstruction with coronoidectomy for lengthy mandible advancement (≥ 10 mm) may lead to prominent increase in shear force and result in a costal-cartilage junction fracture, in this situation, alloplastic prosthesis could be a better choice. We also suggested that coronoidectomy should be carefully considered unless necessary.
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Affiliation(s)
- Yi Mao
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, 200011, China
| | - Xuzhuo Chen
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, 200011, China
| | - Shiqi Yu
- Shanghai Ninth People's Hospital, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, 200011, China
| | - Weifeng Xu
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, 200011, China
| | - Haiyi Qin
- National Die and Mold CAD Engineering Research Center, Shanghai Jiao Tong University, Shanghai, 200011, China
| | - Jinze Zhen
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, 200011, China.
| | - Yating Qiu
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, 200011, China.
| | - Shanyong Zhang
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, 200011, China.
| | - Chi Yang
- Department of Oral Surgery, Ninth People's Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, and Shanghai Key Laboratory of Stomatology & Shanghai Research Institute of Stomatology, Shanghai, 200011, China
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18
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Zhang Z, Lu Y, Lu L, Bai X. Distraction osteogenesis for patients with severe idiopathic condylar resorption. Am J Orthod Dentofacial Orthop 2020; 157:439. [PMID: 32241344 DOI: 10.1016/j.ajodo.2020.01.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 11/04/2019] [Accepted: 01/17/2020] [Indexed: 11/26/2022]
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19
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Kau CH, Almakky O, Louis PJ. Team approach in the management of revision surgery to correct bilateral temporomandibular joint replacements. J Orthod 2020; 47:156-162. [PMID: 32126863 DOI: 10.1177/1465312520908276] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This case report describes the successful second surgical treatment of a 26-year-old white female patient with a retrognathic mandible and previous bilateral total joint prostheses placement. The patient had previously presented with bilateral idiopathic condylar resorption (ICR) which caused clockwise mandibular rotation and resulted in anterior open bite and a retrognathic mandible. The patient had undergone definitive corrective for the ICR where condylectomies were performed bilaterally. In addition, total joint prostheses using 'stock joints' were used to restore the condyle and glenoid fossa on both sides. Although the previous surgery corrected the anterior open bite and restored the condyles, the patient was still suffering from joint symptoms (significant pain), restricted mandibular movements, increased overjet (12 mm) and a retrognathic mandible. The treatment plan included a combined orthodontic surgical approach: (1) bimaxillary orthognathic surgery: a surgical procedure on the mandible to reposition the prosthetic joints and correct the mandible position, and a segmental LeFort I to expand the maxilla; and (2) post-surgical orthodontics treatment to detail the occlusion. At the end of the treatment, good aesthetic and functional results were obtained with the cooperation of two specialties. This case emphasises the importance of three-dimensional planning and multidisciplinary treatment when addressing complex jaw movements. It also emphasises the importance orthodontic planning and collaboration with the orthodontist.
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Affiliation(s)
- Chung H Kau
- Department of Orthodontics, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Omar Almakky
- Department of Orthodontics, School of Dentistry, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Patrick J Louis
- Department of Oral and Maxillofacial Surgery, School of Dentistry, University of Alabama at Birmingham, AL, USA
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20
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Luo E, He Z. [Treatment of dentofacial deformities secondary to condylar resorption]. HUA XI KOU QIANG YI XUE ZA ZHI = HUAXI KOUQIANG YIXUE ZAZHI = WEST CHINA JOURNAL OF STOMATOLOGY 2020; 38:1-5. [PMID: 32037758 PMCID: PMC7184297 DOI: 10.7518/hxkq.2020.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 11/02/2019] [Indexed: 02/05/2023]
Abstract
Treating dentofacial deformities secondary to condylar resorption is a remarkable clinical challenge. Combined orthodontic treatment and orthognathic surgery is currently the main treatment scheme and is often integrated with temporomandibular joint surgery or conservative treatment according to the severity of condylar resorption. This paper discussed the etiology, clinical features, imaging features, treatment options, and prophylaxis of condylar resorption.
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Affiliation(s)
- En Luo
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ze He
- State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Dept. of Orthognathic and Temporomandibular Joint Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
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21
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Morphologic changes in idiopathic condylar resorption with different degrees of bone loss. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:332-340. [DOI: 10.1016/j.oooo.2019.05.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 05/12/2019] [Accepted: 05/30/2019] [Indexed: 11/23/2022]
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22
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Cagna DR, Donovan TE, McKee JR, Eichmiller F, Metz JE, Albouy JP, Marzola R, Murphy KR, Troeltzsch M. Annual review of selected scientific literature: A report of the Committee on Scientific Investigation of the American Academy of Restorative Dentistry. J Prosthet Dent 2019; 122:198-269. [PMID: 31405523 DOI: 10.1016/j.prosdent.2019.05.010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2019] [Accepted: 05/15/2019] [Indexed: 12/13/2022]
Abstract
This comprehensive review of the 2018 dental literature is provided to inform busy dentists about progress in the profession. Developed by the Committee on Scientific Investigation of the American Academy of Restorative Dentistry, each author brings discipline-specific expertise to one of the 8 sections of the report including (1) prosthodontics; (2) periodontics, alveolar bone, and peri-implant tissues; (3) implant dentistry; (4) dental materials and therapeutics; (5) occlusion and temporomandibular disorders; (6) sleep-related breathing disorders; (7) oral medicine and oral and maxillofacial surgery; and (8) dental caries and cariology. The report targets important information that will likely influence day-to-day treatment decisions. Each review is not intended to stand alone but to update interested readers so that they may visit source materials if greater detail is desired. As the profession continues its march toward evidence-based clinical decision-making, an already voluminous library of potentially valuable dental literature continues to grow. It is the intention of this review and its authors to provide assistance in navigating the extensive dental literature published in 2018. It is our hope that readers find this work useful in the clinical management of patients moving forward.
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Affiliation(s)
- David R Cagna
- Professor, Associate Dean, and Residency Director, Department of Prosthodontics, University of Tennessee Health Sciences Center, College of Dentistry, Memphis, Tenn.
| | - Terence E Donovan
- Professor and Head of Biomaterials, Department of Restorative Sciences, University of North Carolina School of Dentistry, Chapel Hill, NC
| | - James R McKee
- Private practice, Restorative Dentistry, Downers Grove, Ill
| | | | - James E Metz
- Private practice, Restorative Dentistry, Columbus, Ohio
| | - Jean-Pierre Albouy
- Assistant Professor, Department of Restorative Sciences, University of North Carolina School of Dentistry, Chapel Hill, NC
| | | | - Kevin R Murphy
- Associate Clinical Professor, Department of Periodontics, University of Maryland College of Dentistry, Baltimore, MD; Private practice, Periodontics and Prosthodontics, Baltimore, MD
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23
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Verhelst PJ, Van der Cruyssen F, De Laat A, Jacobs R, Politis C. The Biomechanical Effect of the Sagittal Split Ramus Osteotomy on the Temporomandibular Joint: Current Perspectives on the Remodeling Spectrum. Front Physiol 2019; 10:1021. [PMID: 31447704 PMCID: PMC6692453 DOI: 10.3389/fphys.2019.01021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 07/24/2019] [Indexed: 01/18/2023] Open
Abstract
The sagittal split ramus osteotomy is a key approach for treating dentofacial deformities. Although it delivers excellent results, the sagittal split ramus osteotomy is believed to induce stress to the temporomandibular joint. Potential stress inducers could be classified as intra- and postoperative factors resulting in an inflammatory response and molecular cascades, which initiate physiological remodeling. Occasionally, this process exceeds its capacity and causes pathological remodeling, through either degenerative joint disease or condylar resorption. Hard evidence on how orthognathic surgery causes inflammation and how this inflammation is linked to the spectrum of remodeling remains scarce. Current concepts on this matter are mainly based on clinical observations and molecular mechanisms are extrapolated from fundamental research in other body parts or joints. This perspective study provides an overview of current knowledge on molecular pathways and biomechanical effects in temporomandibular joint remodeling. It provides research directions that could lead to acquiring fundamental evidence of the relation of orthognathic surgery and inflammation and its role in remodeling. Performing osteotomies in animal models and identifying inflammatory mediators as well as their effect on the joint seem promising. Patients affected by pathological remodeling can also provide samples for histological as well as molecular analysis. Individual susceptibility analysis by linking certain suspect phenotypes to genetic variation could identify the cause and molecular pathway responsible for degenerative joint disease and condylar resorption, ultimately leading to clinically applicable treatment and prevention strategies.
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Affiliation(s)
- Pieter-Jan Verhelst
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Fréderic Van der Cruyssen
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Antoon De Laat
- Department of Oral Health Sciences, KU Leuven, Leuven, Belgium.,Department of Dentistry, University Hospitals Leuven, Leuven, Belgium
| | - Reinhilde Jacobs
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Dental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Constantinus Politis
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium
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24
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He Z, Ji H, Du W, Xu C, Luo E. Management of condylar resorption before or after orthognathic surgery: A systematic review. J Craniomaxillofac Surg 2019; 47:1007-1014. [DOI: 10.1016/j.jcms.2019.03.012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2018] [Revised: 03/04/2019] [Accepted: 03/11/2019] [Indexed: 10/27/2022] Open
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